Home Health ICD-9/ICD-10 Alert

Published on Mon Oct 15, 2012 PDF

You may want to order a 2013 ICD-9 manual after all.

You know that the ICD-10 implementation date is slated for Oct. 1, 2014. But how will it work in practical day-to-day coding terms? Take a look at this breakdown from Sharon Molinari, RN, HCS-D, HCS-O, a home health consultant based in Henderson, Nev.

ICD-10 codes will be required for claims reimbursement on patient discharges or service dates that occur on or after Oct. 1, 2014.

For episodes that begin before but end after Oct. 1, 2014, home health agencies must use ICD-10 codes when submitting final codes. However, agencies will be allowed to use a payment group code derived from ICD-9 codes for those claims. Claims that don't meet those requirements will be returned for correction.

Note: You'll need to be able to support both ICD-9 and ICD-10 systems as long as you have patients with a start date prior to Oct. 1 2014.

The transition will also impact annual code updates. Diagnosis codes are added, removed, and revised annually on Oct. 1 to account for new technology and/or updated information on specific conditions. This is why you need a new coding manual each year.

Oct. 1, 2011 marked the last regular annual update to both the ICD-9 and the ICD-10 code sets in anticipation for Oct. 1 2013 when we originally planned to transition to ICD-10. The idea was that there would be limited updates to both code sets for new technologies and diseases, Molinari says. There will be no changes made in 2012. This is good for us because it gives us extra time to prepare for ICD-10, she says.

Tip: Coding manual publishers will likely still offer new content in the manuals, such as scenarios and ICD-10 preparation materials, so purchasing at least one for reference may be a good idea, despite the lack of new codes, Molinari says.

The last changes to the ICD-9 codeset -- for new diseases and new technologies only -- will be effective Oct. 1, 2013.

The Oct. 1, 2014 diagnosis code update will include only limited updates for ICD-10 for new technologies and diseases.

Starting Oct. 1 2015, regular updates for ICD-10 will begin, provided all goes as it should with the implementation date.